Titre du document / Document title

Orlistat in responding obese type 2 diabetic patients : meta-analysis findings and cost-effectiveness as rationales for reimbursement in Sweden and Switzerland

Auteur(s) / Author(s)

RUOF J. ^{(1 2)} ; GOLAY A. ⁽³⁾ ; BERNE C. ⁽⁴⁾ ; COLLIN C. ⁽⁵⁾ ; LENTZ J. ⁽⁶⁾ ; MAETZEL A. ⁽⁷⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Health Services Research Unit, Division of Rheumatology, Center of Internal Medicine, Hannover Medical School, Hannover, ALLEMAGNE
⁽²⁾ Global Health Economics Department, Roche Pharmaceuticals, Basel, SUISSE
⁽³⁾ Teaching Diabetic Division, University Hospital, Geneva, SUISSE
⁽⁴⁾ Department of Medicine, University Hospital, Uppsala, SUEDE
⁽⁵⁾ Business Development, Roche Pharmaceuticals, Stockholm, SUEDE
⁽⁶⁾ Roche Pharmaceuticals, Reinach, SUISSE
⁽⁷⁾ University Health Network, Department of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, CANADA

Résumé / Abstract

OBJECTIVE: The aim of this study is to review the clinical and economic rationale for the reimbursement of orlistat in responding obese patients with type 2 diabetes. METHODS: Data from seven randomized controlled clinical trials of orlistat in overweight and obese patients with type diabetes were pooled. A subgroup analysis involving patients who achieved a response (defined as a weight loss of ≥ 5% after 1; weeks of treatment) was conducted. The outcomes of the pooled analysis were then used to construct a Markov health economic model covering an 11-y period. The incidences of diabetes-related micro- and macrovascular complications were derived from the United Kingdom Prospective Diabetes Study. The effects of changes in body mass index, and the impact o micro- and macrovascular complications on utilities were derived from published sources. Publicly available cost data were usec and are presented here in 2001 Euros. Discounting of 3% was applied. A probabilistic sensitivity analysis was conducted tc examine the robustness of results. RESULTS: A total of 1249 patients treated with orlistat and 1230 given placebo were eligible for the intent-to-treat analysis. A the end of the study period, 23% of orlistat patients achieved a weight reduction of >5%. These patients showed a mear decrease in HbA1C of 1.16%, a weight reduction of 8.6 kg, a reduction in total cholesterol of 5.3% and a reduction in systolic blood pressure of 5.2 mmHg. The base-case economic analysis revealed costs per quality-adjusted life year gained of?14 000 ir Sweden and?13 600 in Switzerland. CONCLUSION: The data presented here support the utilization and reimbursement of orlistat in overweight and obese diabetic patients who respond to the treatment.

Revue / Journal Title

International journal of obesity   ISSN 0307-0565   CODEN IJOBDP 

Source / Source

2005, vol. 29, n^o5, pp. 517-523 [7 page(s) (article)] (31 ref.)

Langue / Language

Anglais

Editeur / Publisher

Nature Publishing, Basingstoke, ROYAUME-UNI  (1977) (Revue)

Mots-clés anglais / English Keywords

Public health ; Metabolic diseases ; Endocrinopathy ; Nutrition disorder ; Enzyme ; Hydrolases ; Esterases ; Carboxylic ester hydrolases ; Triacylglycerol lipase ; Enzyme inhibitor ; Europe ; Nutritional status ; Treatment ; Chemotherapy ; Costs ; Switzerland ; Sweden ; Cost analysis ; Patient ; Type 2 diabetes ; Human ; Orlistat ; Obesity ;

Mots-clés français / French Keywords

Santé publique ; Métabolisme pathologie ; Endocrinopathie ; Trouble nutrition ; Enzyme ; Hydrolases ; Esterases ; Carboxylic ester hydrolases ; Triacylglycerol lipase ; Inhibiteur enzyme ; Europe ; Etat nutritionnel ; Traitement ; Chimiothérapie ; Coût ; Suisse ; Suède ; Analyse coût ; Malade ; Diabète type 2 ; Homme ; Orlistat ; Obésité ;

Mots-clés espagnols / Spanish Keywords

Salud pública ; Metabolismo patología ; Endocrinopatía ; Trastorno nutricíon ; Enzima ; Hydrolases ; Esterases ; Carboxylic ester hydrolases ; Triacylglycerol lipase ; Inhibidor enzima ; Europa ; Estado nutricional ; Tratamiento ; Quimioterapia ; Coste ; Suiza ; Suecia ; Análisis costo ; Enfermo ; Diabetes de tipo 2 ; Hombre ; Orlistat ; Obesidad ;

Mots-clés d'auteur / Author Keywords

orlistat ; cost-effectiveness ; diabetes ; reimbursement ; meta-analysis ;

Localisation / Location

INIST-CNRS, Cote INIST : 18243, 35400012599164.0100